Virtual Reimbursement Manager

Responsibilities

• Reactively support multiple accounts in a specified geographic region through the access process.
• Execute the collaborative territory strategic plan through partnership with internal and external stakeholders, including sales, market access, and other collaboration partners.
• Ensure understanding of coverage, access process, and reimbursement services.
• Demonstrate unwavering support and a consultative approach to help offices obtain insurance authorization and/or reimbursement of products for appropriate patients.
• Have a direct impact on a patient’s ability to access the therapies they need.
• Manage daily activities that support appropriate patient access to our client’s products in the provider offices.
• Serve as payer expert for defined geography and able to communicate payer changes to key stakeholders in a timely manner.
• Offer office education during the entire access process, which may include formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, and appeals.
• Educate offices using approved materials provided by the client.
• Educate physician office staff on the use of our client’s patient support services, including web-based provider portals.

Requirements

• Demonstrated understanding of access, coverage, and reimbursement issues in the retail channel, including commercial and federal health care program utilization management tools such as prior authorization, step edits, and denials.
• Demonstrated ability to educate offices on access processes – including but not limited to: experience educating HCPs on client-specific Patient Service programs (i.e., copay, bridge, patient assistance, etc.), experience delivering educational presentations.
• Advanced knowledge of medical insurance terminology.
• Expertise in Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B & D.

Qualifications

• Bachelor’s Degree.
• Minimum two years of experience in public or private third-party reimbursement or access arena or pharmaceutical industry in managed care or clinical support.

Skills

• Demonstrated initiative, resourcefulness, and a results-oriented mindset.

Pay

The annual base salary for this position ranges from $140,000 to $150,000. The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate’s qualifications, skills, competencies, and proficiency for the role.

Schedule

Not specified.

Benefits

• Competitive compensation package.
• Health benefits to include Medical, Dental, and Vision.
• Company match 401k.
• Flexible paid time off (PTO) and sick time.